| Organization Name: | METROEAST ENDOSCOPIC SURGERY CENTER |
| NPI Number: | 1063838357 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAKEEL AHMED (OWNER) |
| Mailing Address: | 5023 N Illinois St Suite 3 Fairview Heights |
| State: | IL US |
| Postal Code: | 622083453 |
| Phone Number: | 6182330700 |
| Fax Number: | 6182350471 |
| NPI Enumeration Date: | 03/11/2014 |
| NPI Last Update Date: | 03/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 7003185 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |